Provider Demographics
NPI:1194341065
Name:PATEL, PRERANA PUROHIT (LPC)
Entity type:Individual
Prefix:MRS
First Name:PRERANA
Middle Name:PUROHIT
Last Name:PATEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 POMEROY AVE APT 1417
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-1778
Mailing Address - Country:US
Mailing Address - Phone:508-471-6823
Mailing Address - Fax:
Practice Address - Street 1:34 YORK ST
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2473
Practice Address - Country:US
Practice Address - Phone:203-453-2220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3980101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health